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Increased intakes of vitamin D during pregnancy may reduce
the development by about 25 per cent, suggests a study with
over 20,000 Norwegian women.

The risk of pre-eclampsia was 27 per cent lower in women who
consumed vitamin D supplements with daily doses of 10 to 15
micrograms, compared to women who did not take supplements,
according to researchers from the Norwegian Institute of Public
Health.

However, a correlation between vitamin D intake and omega-3
fatty acid intake was observed, and the researchers noted that
“further research is needed to disentangle the separate effects
of these nutrients”.

Pre-eclampsia, affecting two to three per cent of all pregnancies,
occurs when a mother’s blood pressure rises to the hypertensive
range, and excretion of protein in the urine becomes too high.
It is estimated to be responsible for about 60,000 deaths worldwide.

It is not known why some expectant mothers develop pre-eclampsia,
although oxidative stress has been proposed to play a part.
The role of antioxidants to reduce oxidative stress had been
supported by a small clinical trial that linked vitamin C and
E intake to fewer biomarkers for pre-eclampsia for predominantly
low-risk participants.

However, subsequent studies, including a study published in
The New England Journal of Medicine (Vol. 354, pp. 1796-1806)
and a Cochrane Systematic Review (2007, Issue 4), found that
vitamins C and E had no effects on the risk of pre-eclampsia.

The new study, published in Epidemiology suggests that vitamin
D supplementation may reduce the risk of developing the potentially
fatal condition.

Led by Helle Margrete Meltzer, the researchers examined the
relationship between vitamin D intakes during pregnancy and
the risk of pre-eclampsia in 23,423 would-be first time mothers
participating in the Norwegian Mother and Child Cohort Study.

The women answered a general health questionnaire at the fifteenth
week of pregnancy and again at the thirtieth week, while a
food frequency questionnaire was administered at week 22.

According to the Norwegian findings, women with a daily intake
of between 15 and 20 micrograms of vitamin D from diet and
supplements had a 24 per cent lower risk of developing pre-eclampsia
compared to women who consumed less than 5 micrograms per day.

The overriding benefits were observed for vitamin D from supplements,
with a daily dose of 10 to 15 micrograms linked to a 27 per
cent reduction, compared to women who did not take supplements.

“These findings are consistent with other
reports of a protective effect of vitamin D on pre-eclampsia
development,” wrote Meltzer and her co-workers.

“However, because vitamin D intake is highly
correlated with the intake of long chain omega-3 fatty acids
in the Norwegian diet, further research is needed to disentangle
the separate effects of these nutrients,” they concluded.

Nearly 64 percent of Americans surveyed are unaware sunscreen
hinders the body's ability to produce vitamin D - a nutrient
found to support the immune system, bone strength, colon health
and more.* The survey was conducted by WELLESSE, manufacturers
of a liquid vitamin D3 supplement.

"Vitamin D is important to overall health. People need
to be aware that sunscreen, even at SPF15, blocks more than
90 percent of the sun's rays used to produce this vital vitamin," warns
Dr. Michael Holick, MD, PhD of Boston University.

The American Academy of Dermatology recommends that the public
obtain vitamin D from nutritional sources and dietary supplements,
and not from unprotected exposure to ultraviolet (UV) radiation
from the sun or indoor tanning devises, as UV radiation is
a known risk factor for the development of skin cancer. (1)

For optimal health, regular sunscreen users should consider
nutritional vitamin D sources from their diet. But often dietary
sources, including mackerel, sardines, salmon or fortified
milk are not frequently consumed by Americans in the amounts
needed to satisfy the daily allowance. An option is a liquid
supplement such as Wellesse Liquid Vitamin D3 which is easy
to swallow and provides flexible dosing for the whole family.
The Recommended Daily Value for Vitamin D is 400 IU for adults.
Holick notes, "Myself and other experts in vitamin D research
recommend between 1000-2000 IU/day depending on your age and
diet."

Vitamin D deficiency has garnered the attention of leading
scientific and public health organizations. In April, The Archives
of Internal Medicine reported that over 75 percent of Americans
have vitamin D insufficiency.(2) Last fall, The American Public
Health Association called Vitamin D deficiency/insufficiency "a
major public health concern for both children and adults in
the United States." (3)

Populations who may need additional vitamin D, according to
the National Institutes of Health Office of Dietary Supplements
include breastfed infants, people ages 50 and older, those
with limited sun exposure, with dark skin, with fat mal-absorption
and the obese.

Wellesse liquid Vitamin D3 is convenient for the whole family.
It is available at Walgreens, Costco, Vitacost.com, Drugstore.com,
and Amazon.com. Suggested retail price is $6.89 for a 16-ounce
bottle.

CHICAGO, June 15, 2009-Body mass index (BMI) should be taken
into account when assessing a cancer patient’s vitamin D status,
according to researchers at Cancer Treatment Centers of America
(CTCA), who found that obese cancer patients had significantly
lower levels of vitamin D compared to non-obese patients.

The association between vitamin D and obesity remains unsettled
with studies reporting conflicting findings on the relationship
between the two. This association assumes even greater importance
in cancer because of the alleged role of vitamin D in cancer.

"Currently, the dietary recommendations for vitamin D
do not take into account a patient’s BMI," said Carolyn
Lammersfeld, national director of nutrition for CTCA and a
principal investigator in the study. "We investigated
the relationship between vitamin D and BMI in a large sample
of cancer patients and found that as BMI groups increased from
normal to overweight or obese classifications, there was a
significant decrease in vitamin D."

The researchers evaluated a group of 740 cancer patients seen
at CTCA from January 2008 to June 2008. Of the 740 patients,
303 were male and 437 female, with a mean age at presentation
of 55.7 years (SD = 10.2). The mean BMI was 27.9 kg/m2 (SD
= 6.7). The most common cancers were lung (134, 18.1%), breast
(131, 17.7%), colorectal (97, 13.1%), pancreatic (86, 11.6%),
prostate (45, 6.1%) and ovarian (39, 5.3%). The mean vitamin
D (serum 25(OH)D) was 21.9 ng/ml (SD = 13.5).

The study concluded that obese cancer patients (BMI >=30
kg/m2) had significantly lower levels of vitamin D compared
to non-obese patients (BMI <30 kg/m2). BMI should be taken
into account when assessing a patient’s vitamin D status and
more aggressive vitamin D supplementation should be considered
in obese cancer patients, researchers determined.

This study was presented at the American Society of Clinical
Oncology (ASCO) annual meeting, May 29-June 2, 2009, and was
publicly released on ASCO’s Web site, www.asco.org, on May
14, 2009.

CHICAGO, June 15, 2009-Vitamin D deficiency was found to be
prevalent in cancer patients regardless of nutritional status,
according to the results of a recent study conducted at Cancer
Treatment Centers of America (CTCA). Based on these results,
CTCA researchers determined that screening for vitamin D deficiency
and aggressive vitamin D repletion should be considered for
all people with cancer.

"While emerging evidence suggests the protective role
of vitamin D in cancer, vitamin D status is not routinely assessed
in cancer patients despite the high prevalence of malnutrition
in this population," said Carolyn Lammersfeld, national
director of nutrition for CTCA and a principal investigator
in the study.

During the study, a consecutive case series of 737 cancer
patients (302 male and 435 female) seen at CTCA between January
- June 2008, were assessed for nutritional status and categorizes
into three distinct classes of nutritional status: well nourished,
moderately malnourished and severely malnourished. The mean
age at presentation was 55.7 years (SD = 10.2) and the most
common cancer types were lung (133, 18%), breast (131, 17.8%),
colorectal (97, 13.2%), pancreatic (86, 11.7%), prostate (44,
6%) and ovarian (38, 5.2%).

Before the study, the researchers hypothesized that malnutrition
could contribute to vitamin D deficiency and therefore expected
mean serum 25-hydroxy-vitamin D [25(OH)D] levels to be significantly
lower in malnourished oncology patients. However contrary to
what they expected, vitamin D deficiency was found to be prevalent
in cancer regardless of nutritional status.

This study was presented at the American Society of Clinical
Oncology (ASCO) annual meeting, May 29-June 2, 2009, and was
publicly released on ASCO’s Web site, www.asco.org,
on May 14, 2009.

Vitamin D deficiency may raise caesarean risk

NEW YORK (Reuters Health) - Women with insufficient vitamin
D intake during pregnancy may be at increased risk for birth
by caesarean section, study findings suggest.

Of 253 women who gave birth in a Boston, Massachusetts hospital,
those deficient in vitamin D were nearly 4-times more likely
to deliver by caesarean section than women with higher levels
of vitamin D, report Dr. Michael F. Holick and colleagues.

Women with insufficient vitamin D intake during pregnancy
may be at increased risk for birth by caesarean section, study
findings suggest.

Ted Rhodes

"Vitamin D is critically important for muscle function," Holick,
of Boston University School of Medicine, told Reuters Health.

Thus, it is not at all surprising that pregnant women, who
are at very high risk for vitamin D deficiency, have an associated
increased risk for caesarean birth, Holick said.

Individual vitamin D levels vary according to supplementation
and the skin's ability to convert direct sunlight exposure
to 25-hydroxyvitamin D in blood.

In this study, Holick and colleagues assessed post-delivery
blood vitamin D levels among women who were about 25 years
old on average and lived in the Boston area for their entire
pregnancy.

One-hundred thirty of the women were Hispanic, 29 were non-Hispanic
white, and 94 were non-Hispanic black, the researchers report

Holick's group defined vitamin D deficiency at the Centers
for Disease Control and Prevention level of less than 37.5
nanomoles per liter (15 nanograms per milliliter) of 25-hydroxyvitamin
D in blood.

According to a report in the Journal of Clinical Endocrinology
and Metabolism, the investigators noted caesarean delivery
among 28 percent of the women deficient in vitamin D, but in
just 14 percent of those with vitamin D levels above 37.5 nanomoles
per liter.

Holick's team also noted lower average vitamin D levels among
women who had caesarean versus vaginal delivery.

In a separate study, Holick's team identified vitamin D deficiency
among more than three-quarters of moms and newborns despite
the moms' daily ingestion of prenatal vitamins and 2 glasses
of milk during pregnancy.

AFP/File – A sunrise in Florida. Teens with lower levels
of vitamin D have a higher risk of heart disease and diabetes
…

DALLAS – New research in teenagers links low levels of vitamin
D to high blood pressure and high blood sugar, which can lead
to ominous early health problems. The "sunshine" vitamin
is needed to keep bones strong, but recent research has linked
vitamin D to other possible health benefits. The teen study
confirms results seen in adults, linking low levels with risk
factors for heart disease, the researchers said.

Teens in the study with the lowest vitamin D levels were
more than twice as likely to have high blood pressure and high
blood sugar. They were also four times more likely to have
metabolic syndrome, defined as have three of more conditions
that contribute to heart disease and diabetes — including high
blood pressure, high blood sugar, big waists and high cholesterol.
The study's leader, Jared Reis of Johns Hopkins Bloomberg School
of Public Health, said more research will be needed to determine
if vitamin D is really behind the health problems and whether
getting more would make a difference.

"We're showing strong associations that need to be followed
up," he said.
The findings were being presented Wednesday at an American
Heart Association conference in Palm Harbor, Fla.

A former president of the heart group said there's much to
be learned about the apparent connection.

"We're at the tip of the iceberg," said Dr. Robert
Eckel.
The body makes vitamin D when exposed to sunlight's ultraviolet
rays. Getting about 15 minutes of sunlight a few times a week
is generally enough. Vitamin D is also in fortified foods like
milk and in salmon and other oily fish.

The American Academy of Pediatrics recently doubled its recommended
amount of vitamin D for children and teens to 400 units daily
— the equivalent of drinking four cups of milk. The pediatricians
group said kids who don't get enough should take vitamin supplements.
The teen study looked at about 3,600 boys and girls ages 12
to 19 who took part in a government health survey from 2001
to 2004. The researchers used measurements of vitamin D from
blood tests.

On average, none of the teens were getting enough vitamin
D. Whites had the highest levels, blacks had the lowest levels
and Mexican-Americans had levels in between.

One reason for the difference, experts say, could be that
it takes fair skin less time to absorb vitamin D from the sun
than darker skin. Also, Reis said, blacks may be skipping milk
because they are more likely to be lactose intolerant.

Dr. Randal Thomas, director of the cardiovascular health
clinic at the Mayo Clinic in Rochester, Minn., said that it's
likely that vitamin D deficiencies in teens stem from unhealthy
diets and lack of exercise outdoors.

Diabetes and the Vitamin D connection
Holick MF

Vitamin D deficiency, which is common in children and adults,
causes rickets, osteomalacia, and osteoporosis. Most organs
and immune cells have a vitamin D receptor, and some also have
the capacity to metabolize 25-hydroxyvitamin D to 1,25-dihydroxyvitamin
D. 1,25-Dihydroxyvitamin D is a potent immunomodulator that
also enhances the production and secretion of several hormones,
including insulin. Vitamin D deficiency has been associated
with increased risk of type 1 diabetes. Glycemic control and
insulin resistance are improved when vitamin D deficiency is
corrected and calcium supplementation is adequate. 25-Hydroxyvitamin
D (measure of vitamin D status) of less than 20 ng/mL is vitamin
D deficiency and 21 to 29 ng/mL is insufficiency. Children
and adults need at least 1000 IU of vitamin D per day to prevent
deficiency when there is inadequate sun exposure.PMID: 18778589 [PubMed - indexed for
MEDLINE]

Role of vitamin D in the pathogenesis of type 2 diabetes
mellitus.

Vitamin D deficiency has been shown to alter insulin synthesis
and secretion in both humans and animal models. It has been
reported that vitamin D deficiency may predispose to glucose
intolerance, altered insulin secretion and type 2 diabetes
mellitus. Vitamin D replenishment improves glycaemia and insulin
secretion in patients with type 2 diabetes with established
hypovitaminosis D, thereby suggesting a role for vitamin D
in the pathogenesis of type 2 diabetes mellitus. The presence
of vitamin D receptors (VDR) and vitamin D-binding proteins
(DBP) in pancreatic tissue and the relationship between certain
allelic variations in the VDR and DBP genes with glucose tolerance
and insulin secretion have further supported this hypothesis.
The mechanism of action of vitamin D in type 2 diabetes is
thought to be mediated not only through regulation of plasma
calcium levels, which regulate insulin synthesis and secretion,
but also through a direct action on pancreatic beta-cell function.
Therefore, owing to its increasing relevance, this review focuses
on the role of vitamin D in the pathogenesis of type 2 diabetes
mellitus.PMID: 18269634 [PubMed - indexed for
MEDLINE]

Vitamin D2 Is As Effective As Vitamin D3 In Maintaining Concentrations
Of 25-hydroxyvitamin D, Study Suggests

ScienceDaily — Researchers from Boston University School
of Medicine (BUSM) have found that vitamin D2 is equally as
effective as vitamin D3 in maintaining 25-hydroxyvitamin D
status.

Researchers studied healthy adults aged 18-84 who received
either placebo, 1,000 International Units (IU) of vitamin D3,
1,000 IU of vitamin D2, or 500 IU of vitamin D2 plus 500 IU
of vitamin D3 daily for three months at the end of winter to
establish what effect it had on circulating levels of total
25 (OH)D as well as 25(OH)D2 and 25(OH)D3. Sixty percent of
the adults were vitamin D deficient at the start of the study.

Adults who received the placebo capsule daily for three months
demonstrated no significant change in their total 25(OH)D levels
during the winter and early spring. Adults who ingested 1,000
vitamin D2/d gradually increased their total 25(OH)D levels
during the first six weeks. Adults who ingested 1,000 IU of
vitamin D3 had a baseline 25(OH)D that was statistically no
different from the baselines of either the placebo group or
the groups that took 1,000 IU of vitamin D2/d or 500 IU vitamin
D2 plus 500 IU vitamin D3/d. The vitamin D3 group increased
their serum 25(OH)D levels similar to that of the group that
ingested vitamin D2.

The circulating levels of 25-hydroxyvitamin D increased to
the same extent in the groups that received 1,000 IU daily
as vitamin D2, vitamin D3, or a combination of 500 IU vitamin
D2 and 500 IU vitamin D3. The 25-hydroxyvitamin D3 levels did
not change in the group that received 1,000 IU vitamin D2 daily.
One thousand IU of vitamin D2 or vitamin D3 did not raise 25-hydroxyvitamin
D levels in vitamin D deficient subjects above 30 ng/ml.

According to BUSM researchers, vitamin D2 has been the main
stay for the prevention and treatment of vitamin D deficiency
in children and adults and as little as 100 IU of vitamin D2
was found to be effective in the prevention of rickets. Both
vitamin D2 and vitamin D3 form 25-hydroxyvitamin D.

Michael Holick, PhD, MD, director of the General Clinical
Research Center and professor of medicine, physiology and biophysics
at BUSM and senior author of this study, is an internationally
recognized expert in vitamin D and skin research. Most recently,
he gave the keynote address to the Indian Endocrine Society
in India.

“The maintenance of the serum 25(OH)D3 levels was most likely
due to the release of vitamin D3 stored in the body fat since
skin synthesis of vitamin D3 does not occur during the winter
in Boston,” said Holick, who is also director of the Bone Healthcare
Clinic and the vitamin D, Skin and Bone Research Laboratory
at Boston University Medical Center.

Vitamin D intakes in North America and Asia-Pacific countries
are not sufficient to prevent vitamin D insufficiency.

Worldwide, vitamin D status is suboptimal relative to circulating
levels of 25-hydroxyvitamin D (25OHD) needed to prevent a variety
of chronic conditions, however, it has long been assumed that
dietary intake is sufficient to meet needs when sun exposure
is limited. In the USA, mean vitamin D intake from foods is
close to 5 microg, the Dietary Reference Intake (DRI) recommendation
for persons up to 50 years; however, the amount of vitamin
D needed to maintain a sufficient 25OHD level during winter
is >12.5 microg, and that needed for darkly pigmented, veiled,
or sun protected persons is >50 microg. In the USA , most
vitamin D intake from foods is provided by fortification. Canada
and New Zealand have fewer fortified choices, and intakes are
correspondingly lower. Supplement use can increase mean intake
to >12.5 microg but does not always reach those who need
it most. Serum 25OHD levels in New Zealand reveal much more
insufficiency than expected, especially for Pacific people
and Mäori; low serum 25OHD concentrations are seen throughout
the Asia-Pacific region. Fortification and supplementation
may be effective to achieve intakes of 12.5 microg vitamin
D in some of the population, but for many achieving the amount
needed in the absence of skin synthesis requires intakes above
the current upper level for vitamin D of 50 microg.PMID: 17218094 [PubMed - indexed for
MEDLINE]